Gastric ulceration

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Sections available in full article Introduction, Presenting signs, Acute presentation, Pathogenesis, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Monitoring, Subsequent management, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Mr James Simpson SDA BVM&S MPhil MRCVS
Dr Ken Harkin DVM DipACVIM

Introduction

  • Superficial erosions - more common than deep ulceration.
  • Cause : drugs (especially corticosteroids, non-steroidal anti-inflammatory drugs), mast cell neoplasia, hepatic disease, renal disease, gastric neoplasia, chronic gastritis, gastroma, Helicobacter.
  • Signs : vomiting, hematemesis, melena and weight loss.
  • Diagnosis : gastroscopy.
  • Treatment : eliminate underlying cause, H2 antagonists, sucralfate.
  • Prognosis : may perforate → septic peritonitis and death.

Diagnosis

Clinical signs

  • Anemia.
  • Signs referrable to any predisposing disease.

Diagnosis

Differential diagnosis



Melena
  • Eosinophilic gastroenteritis Enteritis: eosinophilic.
  • Intestinal neoplasia Small intestine neoplasia , eg lymphosarcoma, adenocarcinoma.
  • Granulomatous enteritis:
    • Clotting defect.
    • Hepatic disease.

Sequelae

Prognosis

  • Good for drug induced ulceration.
  • Guarded for hepatic and renal disease.
  • Poor for neoplasia.

Expected response to treatment

  • Control of any hemorrhage and vomiting within 1-2 days of starting treatment.
  • Healing of ulcer within 7-10 days.

Reasons for treatment failure

  • Failure to recognize and treat predisposing disease.

Sources

Publications

Refereed papers

  • Boothe D M (1999) Gastrointestinal pharmacology. Vet Clin North Am Small Anim Pract 29 (2), 343-376.
  • Penninck D &Tidwell A (1997) Ultrasonography of gastric ulceration in the dog. Vet Radiol 38 , 308-312.
  • Meddings J B et al(1995) Non invasive detection of NSAID-induced gastropathy in dogs. Am J Vet Res 56 , 977-981.
  • Jenkins C C & DeNovo R C (1991) Omeprazole - a potent anti-ulcer drug. Comp Cont Ed Prac Vet 13 , 1578-1583.
  • Moreland K J (1988) Ulcer disease of the upper gastrointestinal tract in small animals. Comp Cont Ed 10 , 1256-1278.

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